Candice Nicole Dienberg, LCSW, SAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9228-123 Issued in WI

Practice address

6510 Grand Teton PLZ Ste 402
Madison, WI 53719-1029

Phone

(855) 458-4966

Fax

(608) 841-1200

NPI assigned

Mar 4, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1376968073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 402",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "855-458-4966",
            "fax_number": "608-841-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ STE 402",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "855-458-4966",
            "fax_number": "608-841-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Gammon Ln",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537192210",
            "country_code": "US",
            "telephone_number": "608-417-8144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIENBERG",
        "first_name": "CANDICE",
        "middle_name": "NICOLE",
        "credential": "LCSW, SAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15826-131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9228-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Diehl, APNP
• Thomas Diehl, MD
• Virginia A Diehl, R.N.
• Helita Jacqueline Diels
• Gretchen A Diem, PHD
• Danielle A Dieringer, MSSW, LCSW
• Matthew Russell Dierks, PHARM.D.
• Ward Dieter, PA
• Julie Mary Dieterle, P.T.
• Michael Gerald Dieterle, MD, PHD

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.